The regular occurrence of a peak due to an unidentified substance (X) in the gas chromatographic traces obtained from phenolic extracts of urine from human pregnant and non-pregnant females has been reported. The biphasic excretion of X with maxima in the luteal phase of the ovulatory cycle and relatively high levels in the first trimester of pregnancy were noteworthy and suggested that the substance may have a biological significance. Close similarities between the excretory pattern, the chemical and chromatographic properties of X and of those of the known phenolic steroids suggested initially that this compound was steroidal in nature. The same, or a similar, substance seems to be excreted in the vervet monkey (Cercopithecus aethiops pygerythrus). We now report the excretory pattern of X in more detail, the isolation of the pure compound from pooled pregnancy urine and the chemical structure. The structure determined by mass spectrometry, IR spectroscopy and NMR spectrometry is: trans-(+/-)-3,4-bis[(3-hydroxyphenyl)methyl]dihydro-2-(3H)-furanone (HPMF) and was confirmed by synthesis.
BackgroundIn 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program.MethodIn a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments.DiscussionWe aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study.Trial registrationDutch trial register: NTR3092
Abstract-Mass spectra of 6 TMSdisaccharides of type aldohexosyl-( I +x)-fructose, in which x varies from 1 to 6, were compared and could be divided into two main groups i.e.
Abatraet-The mass spectra of 18 trimethylsilyl disaccharides containing only aldohexoses, connected via all possible linkages (I d 1) to (1 -+ 6), were compared. These spectra could be divided into three main groups: (1 + 1) disaccharides, (1 + 2), (1 -+ 3), (1 +'4) disaccharides and (1 -+ 5), (I + 6) disaccharides.(t + Zf, (I -+ 3) and (1 -+ 4) disaccharides could be distinguished on the basis of two ratios of peak intensities. (i + 5) and (1 -+ 6) disaccharides could not be distinguished. Also, the mass spectra of 4 trimethylsilyl trisaccharides built up from aldohexose-s only were recorded. The spectra of three aldopentose containing disaccharides showed that the monosaccharide sequence as well as the position of the glycosidic link could be determined.
The high-performance liquid chromatographic (HPLC) behaviour of basic pharmaceutical substances is strongly influenced by the type of column packing, the pH of the mobile phase and the concentration and type of buffer ions. This results in many choices to be made by the chromatographer. In order to assist the chromatographer, an expert system has been developed for the selection of initial HPLC conditions. For this purpose, HPLC data for about 600 basic compounds were used. These compounds belong to the class of CNS-active or cardiovascular drugs. On the basis of this knowledge, which was completed with literature data, rules were defined and a knowledge base was built. The knowledge was implemented in KES (Knowledge Engineering System), a mid-sized expert system shell which runs on an IBM-PC. The system asks for information with respect to the substance(s) to be analysed. This information is given in the form of a table of structural elements. The output of the system specifies the chromatographic characteristics which should be used, i.e., type of stationary phase, mobile phase composition, buffer pH, flow-rate and method of detection.
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